A study of Paclitaxel, Carboplatin, and radiation with or without surgery for treating oesophageal cancer

A recent article published in the Journal of Thoracic Oncology examined the use of a combination of the chemotherapy drugs Paclitaxel and Carboplatin with radiation, and possibly also surgery for the treatment of oesophageal cancer. The standard treatment used currently is the chemotherapy drug Cisplatin combined with radiotherapy. This is referred to as Cisplatin-based chemoradiotherapy or CRT, and usually produces a lot of distressing side effects in patients. Therefore, the authors have examined an alternative therapy for oesophageal cancer. They observed that this new combination treatment was fairly well tolerated by patients, and produced good results in treating oesophageal cancer.

Oesophageal cancer is often related to poor outcomes for patients, and has caused an estimated 13,770 deaths in the USA in 2006. It is fast becoming the most common deadly disease in North America. Generally, only 15-30% of patients with oesophageal cancer are expected to survive up to and beyond 3 years. Very little patients may be cured by surgical removal of tumours alone. Therefore, it is essential to find better ways of treating patients. Cisplatin based CRT has been the most widely used treatment option, but this is often very distressing for patients, as it causes a lot of nausea and vomiting, and may lead to kidney problems in certain cases. High fluid intakes are strongly recommended to protect against kidney damage, and this may be difficult for some. Hence, this trial examined the use of Carboplatin (which produces less distressing side effects) for oesophageal cancer. This was given with Paclitaxel and CRT to improve its effectiveness. The study was performed on patients with advanced stages of the cancer, and most patients showed a rapid improvement in their symptoms after 2 weeks of finishing the entire course of therapy. This treatment also caused fewer side effects in patients, with only 19% of them complaining of nausea and vomiting, and even less developed any other side effects. The 3-year survival was also greater with the use of this treatment, and more than 60% of patients were living longer. The results of this study are very promising, but more trials still need to be done to compare how effective this treatment is compared to the Cisplatin based CRT used today. (Source: Wang H, Ryu J, Gandara D, et al. A Phase II Study of Paclitaxel, Carboplatin, and Radiation with or without Surgery for Esophageal Cancer. Journal of Thoracic Oncology 2007; 2(2); 153-7. : April 2007.)